Summaries of health policy coverage from major news organizations

Bush Arrives in Senegal on First Leg of Africa Tour; AIDS ‘High on Agenda’

President Bush arrived in Senegal today, marking the beginning of his five-day, five-country trip to Africa, during which the AIDS epidemic will be "[h]igh on the president's agenda," the Christian Science Monitor reports (Itano, Christian Science Monitor, 7/8). Bush is scheduled to visit Senegal, South Africa, Botswana, Uganda and Nigeria through July 12. During the trip, the president is expected to promote several initiatives that focus on Africa, including his five-year, $15 billion AIDS initiative (HR 1298), which he signed into law in May. The global AIDS initiative seeks to prevent seven million new HIV infections, provide care for 10 million people living with the disease and provide treatment to two million HIV-positive people. Bush is also expected to discuss the Millennium Challenge Account, which calls for increasing aid to developing countries in exchange for a range of political and economic reforms (Kaiser Daily HIV/AIDS Report, 7/7). Senegal, along with Uganda and Botswana, are likely to be used as "models and examples" for the AIDS initiative, the Monitor reports. Senegal has a 1.4% HIV prevalence rate -- the lowest on the continent -- because the country was one of the first in Africa to "aggressively combat" the disease by utilizing a multipronged approach, including targeting sex workers with HIV/AIDS prevention information and urging young people to delay sexual intercourse, according to the Monitor. In addition, Uganda was one of the first countries on the continent to reduce the number of new HIV infections, and Botswana -- which currently has the highest HIV prevalence in Africa -- is the first country to institute an antiretroviral drug program that provides the medications for free (Christian Science Monitor, 7/8).

Next to South Africa
Bush is set to depart for South Africa late tonight (Superville, AP/Yahoo! News, 7/8). He is scheduled to deliver a speech about AIDS there tomorrow, which some consider a "slight" aimed at President Thabo Mbeki, who has "minimize[d] the seriousness of the threat" posed by HIV/AIDS, the Washington Post reports (Milbank, Washington Post, 7/8). Mbeki's administration has faced criticism from people inside and outside of South Africa for its lack of action in the fight against HIV/AIDS. Although Mbeki has rescinded previous comments he made stating that HIV does not cause AIDS, advocates continue to question his position on the disease (Kaiser Daily HIV/AIDS Report, 12/18/02).

Botswana on Thursday
Bush on Thursday is scheduled to visit Botswana, which is "waging the most comprehensive assault on AIDS" in the world, according to the Philadelphia Inquirer. The country has received grants for its universal access antiretroviral drug program totaling more than $100 million over five years from the Bill & Melinda Gates Foundation and drug maker Merck, and the Harvard AIDS Institute has built a $4.5 million AIDS research laboratory and is training health care workers to address the epidemic. Howard Moffat, the superintendent of Princess Marina Hospital in Botswana, said, "In a way, we are in the most favorable condition to succeed. We have a large responsibility to make sure this doesn't fail" (Raghavan, Philadelphia Inquirer, 7/8). Botswana's antiretroviral program underscores the importance of treatment in the African epidemic. U.N. Special Envoy for HIV/AIDS in Africa Stephen Lewis said, "You can't avoid the issue of treatment anymore. There are 30 million infected people and a minimum of six million who would qualify for treatment. What we've also discovered is that treatment not only keeps people alive, it restores hope" (Christian Science Monitor, 7/8).

Funding the Initiative
Some advocates are concerned that "despite many pledges of help," Bush is bringing "few, if any 'deliverables'" to the continent, as Congress has yet to appropriate any funding for the global AIDS initiative, the Los Angeles Times reports. Pauline Baker, president of Fund for Peace, said, "If you listen to Bush, we have billions already in the pipeline. But in fact, there are a lot of reservations on Capitol Hill about authorizing all these funds" (Wright/Chen, Los Angeles Times, 7/8). Paul Zeitz, executive director of the Global AIDS Alliance, said, "They're phasing the money in very slowly," adding, "There are 25 million people who have already died, three million dying each year, and 8,000 a day. You don't go slow. We're already way behind on this" (Christian Science Monitor, 7/8). Jose Zuniga, president and CEO of the International Association of Physicians in AIDS Care, said, "It is deeply discouraging ... that actual actions might fall short of commitments. The president and Congress have accepted political accolades for a job well done. It is clearly not time yet to celebrate, however, when the risk of inadequate funding for this legislative promise is so great" (IAPAC release, 7/7). Speaking at a press conference yesterday, Irish rock star and AIDS advocate Bono said, "I'm telling you, if President Bush delivers on his one-two punch, the Millennium Challenge Account, $10 billion over three years; this AIDS initiative, $15 billion over five years ... I am ready to trumpet that and give him the applause he deserves," adding, "I'll tell you there will be very few things he will do in his tenure as president of the United States that will impact more lives" (Washington Times, 7/8). Bono, who founded the not-for-profit group DATA, said, "It's not the check-signing that impresses, it's the check cashed" (Bonfield, Cincinnati Enquirer, 7/8).

Letter to Bush Outlines 'Specific Steps'
A group of 31 African physicians and nurses, joined by 63 U.S. colleagues and 12 international health professionals from 11 countries, yesterday sent a letter to Bush calling on him to "take specific steps to combat the global HIV/AIDS epidemic." The letter, coordinated by Physicians for Human Rights' Health Action AIDS project, calls for Congress to appropriate at least $3 billion for HIV/AIDS for fiscal year 2004 and "for the administration to live up to its commitment" of treating two million people living with HIV/AIDS by 2006 and preventing seven million new HIV infections. The letter concludes, "[S]ee people with HIV/AIDS as we see them. We hope that you will see the whole person, a person whose needs extend far beyond the narrow scope of antiretroviral medications and HIV prevention messages, a person who also needs the fulfillment of basic human rights, including clean water and basic sanitation, adequate nutrition, and poverty alleviation, health and education -- hope for the future." The signatories include Dr. Allan Rosenfield, of Columbia University's Mailman School of Public Health; Karen Ivantic-Doucette of Marquette University College of Nursing who is also a member of the Presidential Advisory Council on HIV/AIDS; Dr. Joia Mukherjee, medical director of Partners In Health and director of Zanmi Lasante's HIV Equity Initiative; Dr. Paul Volberding, professor and vice chair of medicine at the University of California-San Francisco and codirector of the USCF-GIVI Center for AIDS Research; Dr. Eric Goosby, CEO of Pangaea Global AIDS Foundation; and former Surgeon General C. Everett Koop (Health Action AIDS release, 7/7).

Media Coverage
The following broadcast programs reported on Bush's trip to Africa:

NPR's "All Things Considered": The program included a segment on Uganda, one of the countries Bush is scheduled to visit and "the only country on the continent that has drmatically slashed its rate of HIV infection." The segment includes comments from Dr. Alex Coutinho, executive director of the AIDS group TASO, and Ruben del Prado of the United Nations AIDS Office in Uganda (Beaubien, "All Things Considered," NPR, 7/7). The segment is available online in RealPlayer.

NPR's "Morning Edition": The program reported that Bush's agenda will allow the president to speak about initiatives at each stop, including HIV/AIDS in Botswana (Edwards, "Morning Edition," NPR, 7/8). This segment is available online in RealPlayer. The program also included a segment on past U.S. presidential involvement in Africa and Bush's interest in AIDS. Bob Edwards interviews Jeffrey Sachs, director of the Earth Institute at Columbia University (Edwards, "Morning Edition," NPR, 7/8). This segment is available online in RealPlayer.

ABCNews' "World News Tonight": The program reports that part of Bush's motivation for the $15 billion AIDS initiative is his Christian faith. The segment includes comments by Bush, National Security Adviser Condoleeza Rice and World Vision President Richard Stearns (Cochran, "World News Tonight," ABCNews, 7/7). The segment is available online in RealPlayer.

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